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An eye specialist who charged the Ontario Health Insurance Plan a “staggering” $6.6 million last year is one of 500 doctors on a secret list billing more than $1 million annually, Health Minister Eric Hoskins said Friday.

He revealed the numbers — but refused to release doctors’ names for privacy reasons — to pressure the Ontario Medical Association as the government seeks to lower the amounts paid for some medical services.

The gambit comes as the Star has been trying for more than two years to get access to physician billings, by name, through access to information legislation. The OMA has opposed the Star’s effort.

A decision expected soon from Information and Privacy Commissioner Brian Beamish will guide Hoskins, who said he won’t “pre-judge or pre-empt” the findings. Two decades ago, then-health minister Jim Wilson was forced to step aside ‎while the information and privacy commissioner investigated, and was later reinstated.

OMA president Dr. Mike Toth accused Hoskins Friday of trying to “negotiate in public” after talks on a contract with the government broke off in January 2015.

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Toth issued a brief statement that did not touch on the high billings. It called for binding arbitration to reach a “fair and predictable physician agreement . . . to strengthen the quality care patients need and deserve.”

Hoskins said he’s willing to consider arbitration but insisted many fees, such as for methadone testing and assessing CT scans and MRIs, are outdated given that technological advances mean tasks and treatments can now be performed much more quickly.

The system is “badly out of balance” with two per cent of doctors — mostly a small cadre of specialists — taking 10 per cent of the $11.6 billion set aside to pay doctors for their services, offices, staff and equipment, he added.

“This isn’t about hard-working family doctors and pediatricians,” said Hoskins, a family physician himself.

“Unpredictable and, frankly, uncontrolled billing by some doctors is a problem that leaves less for family doctors and others.”

Hoskins suggested the OMA play a Robin Hood role in rebalancing fees that “reward volume over value” and leave less for other doctors, nurses and home care.

If the OMA won’t agree to lower fees as the government seeks to eliminate deficits by 2018, Hoskins threatened to impose them as he did in September with across-the-board cuts of 1.3 per cent. That move infuriated doctors.

“If necessary . . . we will be forced to make changes,” Hoskins warned.

The top-billing doctor was an ophthalmologist — one of three specialties that take in the most cash, with 85 of them billing more than $1 million.

Diagnostic radiologists led the pack, with 154 billing $1 million or more. Another 57 cardiologists hit or surpassed the same threshold.

No one was identified as Hoskins and the Star await the decision from Beamish on releasing names and billings.

One of the privacy commissioner’s predecessors advised the legislature 19 years ago that revealing doctor billings by name would be a violation of the Freedom of Information and Protection of Privacy Act.

“Since that time, the ground has shifted in terms of the need for public scrutiny of government spending. Information that was previously considered confidential, such as public servant salaries, expenses and contracts, are now proactively disclosed,” Beamish said Friday.

“Once the decision is released, the minister of health and long-term care will be in a better position to decide whether he may proactively disclose this information.”

A Star attempt to get the names and billings in 2014 was denied. The health ministry’s privacy office said the release would be considered an unjustified invasion of privacy.

Manitoba and British Columbia make physician-identified billings public and Ontario releases an annual list of public servants earning more than $100,000, but only doctors who directly work for hospitals or health centres are on it.

The OMA has argued that physicians are independent contractors, not public servants. As well, the organization says that billings are not the same as earnings because they do not reflect how much doctors have to pay in overhead costs.

New Democrat MPP France Gélinas, who has proposed a private member’s bill to release doctor billings by name, said it would make the information public “for everyone to see and question.”

Progressive Conservative Leader Patrick Brown said he’s concerned that releasing the billings would be “misleading” because the figures do not account for sometimes hefty overhead costs for staff and equipment.

“It’s not actually salary . . . I think transparency is a wonderful thing and if you could actually show salaries then I think that’s fair game.”

Hoskins said the budget for paying doctors was increased by $140 million this year and that the average billing by a physician in the province is $368,000, out of which they must pay their expenses.

That makes them “the best-paid doctors in Canada,” said Hoskins, who noted physicians have billed $744 million more than the budget set for them in the last four years.

“When they bill more than the budget, the money has to come from elsewhere in the health-care system, limiting our ability to invest in home care, hospitals, mental health and other services.”

The fee cuts for doctors last September were on top of a 2.65 per cent across-the-board cut the previous February. There have also been fee cuts targeted at different specialties, and taken together they add up to 6.9 per cent in cuts, the OMA has said.

The government cut fees because it is trying to cap the annual physician services budget at $11.6 billion.

Doctors argue that they are charging beyond the cap because they are doing more work by treating a growing and aging population.

The government contends the physician services budget was set taking demographic changes into account. As well, it argues that a negotiating framework created at the insistence of the OMA allowed it to take unilateral action.

A breakaway group of physicians, Concerned Doctors of Ontario, is planning to hold a rally at Queen's Park on Saturday.

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